舒芬尼与芬太尼镇静效果的临床观察

目的:用脑电双频指数(BispectralIndex,BIS)比较舒芬尼与芬太尼的镇静效果,并观察其对血流动力学和呼吸的影响。方法:选择40例ASAⅠ～Ⅱ级乳腺癌择期手术的患者,随机分为Ⅰ组(舒芬尼0.3μg/kg)和Ⅱ组(芬太尼3μg/kg),每组20例,记录并比较两组入室基础值及给药后1分钟、2分钟、3分钟的BIS值,收缩压,舒张压,心率,血氧饱和度(SpO2)的变化。结果:两组患者给药后BIS值较基础值均下降(P<0.05),Ⅰ组与Ⅱ组同时间点相比BIS值降低更为显著(P<0.05)。两组对血流动力学的影响不大,无显著差异(P>0.05)。两组第1分钟SpO2与基础值比较均没有显著差异(P>0.05),舒芬尼组给药后第2、3分钟的SpO2比芬太尼组降低,有显著性差异(P<0.05)。结论:舒芬尼与芬太尼均有一定程度的镇静作用,且1∶10舒芬尼的镇静作用强于芬太尼。小剂量舒芬尼与芬太尼均能保持血流动力学稳定,有较弱呼吸抑制。

Objective： Through observating the bispectral analysis of quantitative EEG and hemodynamics changes of the performance with sufentanil or fentanyl in patients undergoing radical operation for mammary cancer, we compared sedation effect of sufentanil with fentanyl. Methods： Forty ASA Ⅰ -Ⅱ elective patients were randomly allocated into two groups with twenty cases each： intravenous sufentanil 0.3μg/ kg in group I and fentanyl 3 μg/kg in group Ⅱ. General status of two groups 闸 patients was identical. These patients were recorded BIS, SBP, DBP, HR and SpO2 after sufentanil or fentanyl infusion one minute, two minutes and three minutes. Results： There was no significantly difference among the changes of hemodynamics： DBP, SBP, HR of the patients from T1 to T3 vs To in two groups （P〉0.05）.BIS in group I was significantly lower than that in group II（P〈 0.05）. SpO2 was slight decrease（P〈 0.05） after sufentanil or fentanyl infusion two or three minutes in both groups.And in groupⅠ , SpO2 was significantly lower than that in group Ⅱ（P〈0.05）. Conclusions： The sedation effect of 1：10 sufentanil is better than that of fentanyl. Intravenous anesthesia with sufentanilor fentanyl in patients can make hemodynamics stable and slight respiratory depression.